For cognitive stimulation therapy (CST) and reminiscence therapy, the evidence question is largely settled: both are recommended, non-drug ways to support cognition, mood and quality of life for people living with dementia. The harder question is why, so often, they never make it off the page and into the daily routine of a care home.
A 2025 systematic review in the International Journal of Geriatric Psychiatry (Fisher, Chick, Fossey & Spector) set out to answer exactly that — pulling together nine studies of CST and reminiscence therapy delivered in care homes by care-home staff, and asking what helped and what got in the way.
What the review found
The pattern is strikingly consistent, and it will ring true to anyone who runs a floor. The interventions work when the conditions are right — and the conditions are rarely about the therapy itself.
- Standardised manuals and ready-made resources
- Interventions that are adaptable to each person
- Practical staff training and support
- Not enough staff time and availability
- Limited support from management
- Gaps in funding, space and staffing
Notice what's not on the barriers list: doubts about whether the therapy works. The obstacles are operational — time, resourcing and leadership backing. The review also flagged that the overall quality of the studies was low and that no study gathered the views of people with dementia themselves, so there's still work to do on the evidence. But the implementation message is clear.
An Australian systematic review published the same year (Siette and colleagues, on non-pharmacological therapies in residential aged care) lands in the same place: the tools exist, but everyday delivery depends on workforce capacity and organisational support.
Why this matters here and now
In Australia, this isn't abstract. Most people with dementia live in the community or in residential aged care for years, and the reformed system — with its move to Support at Home and reablement — expects providers to actively support wellbeing and independence, not just deliver tasks. Structured cognitive engagement is one of the clearest ways to do that. The barrier was never the idea; it's making it happen every day, on a real roster.
What this means for your service
- Remove the preparation barrier: use ready-made, standardised activities so a session isn't a project.
- Choose tools that are adaptable to each person's history and ability.
- Make delivery a defined role, not an optional extra squeezed between tasks.
- Get management behind it — the review is blunt that leadership support is decisive.
Where technology fits
Read the facilitators list again — standardised resources, adaptability, easy training — and it reads almost like a design brief. A well-made touchscreen platform delivers exactly those: activities are ready to run (no preparation), adaptable to each person, and simple enough that any staff member can lead a session with minimal training. That directly eases the biggest barrier, staff time, and turns ‘we should do CST’ into something that actually happens on a Tuesday afternoon.
Technology can't manufacture the two things the review says matter most — adequate staffing and genuine management backing. But it can make the most of the time a service does have, and lower the bar to getting started.
The bottom line
The research keeps arriving at the same, oddly hopeful conclusion: the therapies work, and the fixes are practical. Give staff ready-made, adaptable tools, protect a little time, and back it from the top — and cognitive stimulation stops being a good intention and becomes part of the day.
Sources: Fisher E, Chick I, Fossey J, Spector A. Barriers and Facilitators to Implementing Cognitive Stimulation and Reminiscence Therapy for Dementia in Care Homes: Systematic Review. International Journal of Geriatric Psychiatry, 2025. · Siette J et al. Barriers and Facilitators to Implementing Non-Pharmacological Dementia Therapies in Residential Aged Care. Dementia, 2025.